Before Obtaining Asylum, Refugees Must Show The Scars Behind The StoriesLike many medical professionals, Dr. Katherine McKenzie examines the wounds of her patients — but she doesn't treat them. The forensic physician evaluates asylum-seekers' claims of torture.

Before Obtaining Asylum, Refugees Must Show The Scars Behind The Stories

Dr. Katherine McKenzie has examined the wounds of many people. But she doesn't treat them. For the past decade, she has conducted forensic evaluations as director of the Yale Center for Asylum Medicine. It's her job to verify claims of physical torture by individuals seeking asylum in this country. And the decision she makes for each of these people could change their life. When I spoke with her recently, she described what leads people to her clinic door.

KATHERINE MCKENZIE: When we think of asylum seekers, we think of those seeking asylum for political persecution. But there's many other reasons. Most recently, we have seen people who are persecuted, detained, assaulted because of their sexual orientation. And we also have been seeing people who come from Central and South America in particular who are persecuted because of domestic violence or gang violence.

MARTIN: How do they get into your office? I mean, what has happened in their process to get them to that point where they're seeing you for an evaluation?

MCKENZIE: Well, in contrast to someone who is a refugee and comes to this country legally through the State Department, an asylum seeker is someone often who is fleeing their country in a more dramatic way. They feel acutely in danger. And they may obtain a tourist visa and fly to this country. So they're here legally initially, but they can't stay. So they will approach a human rights group or an attorney and say, I would like to seek asylum. Then those groups approach us at the center. And they will say, this person has been persecuted, tortured, assaulted, and she has scars; Dr. McKenzie, could you evaluate her and tell us whether you feel that the story she tells and the scars that she exhibits are consistent?

MARTIN: Can you give us an example of one particular scar and how it coincided with someone's story?

MCKENZIE: There is one man called Pelan (ph), who came from the Democratic Republic of the Congo. And he was a member of an opposition political group. And at one time, he was arrested by government forces who took him to a detention center. And for several days, they detained him in terribly inhumane circumstances in a cell with very little food, many people, unhygienic. But periodically, they took him out and questioned him about his political beliefs and his political involvement, threatening him; if you continue to be part of the opposition group, we will kill you. But they used a bayonet. They cut him in several places on his body with a bayonet. And that resulted in a scar even several years after that happened to him. He also sustained some more nonspecific scars from blunt trauma. He was beaten by the people who interrogated him with batons and with fists. So when I saw him, we talked about everything that had happened to him. And then, as I examined him, I saw scars that clearly, in my medical opinion, were consistent with the injury that he described. And he was granted asylum. And because he was granted asylum, his family from the Democratic Republic of Congo was able to come and join him.

MARTIN: Have you ever been unable to corroborate someone's story?

MCKENZIE: Well, in the last decade in this century, we've seen about 55 clients. And I wouldn't say I've ever seen someone who I thought was absolutely lying. But I certainly have seen cases where the evidence is much weaker. Interestingly, we work with groups who send us clients who tend to be fairly well vetted. So we work with Yale Law School, University of Connecticut Law School, Physicians for Human Rights. And they tend to send us clients who they think have stronger stories.

MARTIN: This is such a complicated job. Because you are hearing these people's stories, you would have a human response to react to someone who had been tortured. Do you ever worry that your judgment - your medical judgment - can be shaped by the compassion you might feel for a particular client?

MCKENZIE: Well, I consider it a privilege to be able to use this training as an internist to use my knowledge to be able to perform these exams. So I go into it thinking that I maybe have something to offer. But it is so important to be an objective medical observer. And that's one reason why we do not provide care because we really need to be objective. And therefore, I have that first and foremost in my mind. I am not this person's advocate necessarily. So I might be glad, in the abstract, that I can assist people in these very vulnerable situations. But when I'm in the room, I really am doing my best to gather this objective evidence to present in court.

MARTIN: Dr. Katherine Mackenzie is the director of the Yale Center for Asylum Medicine in New Haven, Conn. Thanks so much for talking with us, Dr. McKenzie.

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